Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 08026 | AL |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 08026 | AL |
NPI | 1487708012 |
---|---|
Provider Name | Richard A Walker |
First Address | Birmingham, AL 35203-1854 |
Second Address | Birmingham, AL 35203-1854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 20/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010614 | (05) | AL |
C78671 | (02) | AL |